Improvement After Cerebrospinal Fluid Drainage Is Related to Levels of N-Acetyl-Aspartate in Idiopathic Normal Pressure Hydrocephalus

NAA/Cr ratios were decreased in patients with idiopathic normal pressure hydrocephalus, which is consistent with neuronal dysfunction in the frontal white matter. Improved patients had NAA/Cr ratios close to normal, indicating that enough functional neurons are a prerequisite for the cerebrospinal fluid drainage to have an effect.